Home Healthcare Technology Gaining Momentum

Medical technology is moving from the clinic to the home, even as the healthcare industry struggles to adjust to the home-based business model, one expert told Design News.

"The challenge in remote patient monitoring today is not the technology," said Steven Dean, global healthcare segment lead for Freescale Semiconductor. "The technology has been available for at least a decade. Now, it's more an issue of the reimbursement climate."

Speaking on a recent Design News radio broadcast, "Embedded Angles for Medical Products," Dean said that memory, processing, and communications technology have reached the point where many patients could be adequately monitored at home. He cited examples of big companies that have joined the home healthcare technology trend, including Verizon, Motorola Mobility, Qualcomm, and others. He also pointed to a recent study by Juniper Research that says the number of patients monitored via mobile networks will reach three million by 2016.

One of the fast-growing areas in home heathcare is cardiac monitoring, Dean said. More than 500,000 blood pressure monitors are expected to be wirelessly connected to the Internet by 2013. Meanwhile, a variety of medical equipment manufacturers are working on cardiac technology -- including heart rate monitors and electrocardiograms (ECGs) -- that could fit inside a device slightly larger than a conventional Band-Aid.

"Years ago, you'd see (cardiac care) in the clinic, then you saw it in the home, and now you're seeing it connected to your caregiver via wireless means," Dean said.

Technical challenges remain, however. He said engineers will have trouble packing an entire ECG into a bandage because ECGs use multiple leads, which are typically placed across the chest, abdomen, shoulders, and arms. He said the leads can't be eliminated, but added that the central processing portion of the device can be packed into a smaller package. He pointed to several companies, including Corventis Inc., which is making heart failure monitors that fit in a body patch.

I am a big fan of the home healthcare technology trend and hope that it continues to grow.

Another adoption challenge will be the learning curve for the patient to properly use this equipment and feel confident doing so. I know of several older people who could benefit from this technology right now. However, many in this generation are intimidated and confused by computer technology and would not feel comfortable using this type of system (many older people I know do not even use the self-checkout machines at the grocery store, much less feel comfortable with a life-monitoring device). Human factors and user-friendliness must also be at the forefront to have this new option to be accepted.

Yes, I saw the remote monitoring first hand recently when a friend was "admitted" to the hospital from home. The hospital tracked his vitals, etc. remotely. A nurse or doctor visited a few times until he was ready to be "discharged."

This experience came with a handful of postivies. The patient was able to stay in the comfort of his own home (and away from exposure to staph and MRSA). The hospital didin't have to give up a very expensive room.

This is encouraging. I started hearing about home healthcare about 20 tears ago--it was supposed to be the wave of the future and a healthcare career of the future. It either didn't materialize, or died, apparently temporarily, because of the high costs of personal care by humans. It sounds like there's been a resurgence because of the lower costs of care or assistance that can be provided by newer electronics.

Steve: You and I have talked a little bit about this in the past -- If home healthcare is going to take off, how important is it for physicians to be able to use some kind of different pricing structure? I'm specifically thinking of charging patients for over-the-phone consulting.

I love these discussions! Looking at the US, Remote Patient Monitoring will help solve the runaway healthcare spending/cost issue, but the reimbursement climate must change for the better so this is fully appreciated. There's pent up demand as you say, but the follow-the-money model isn't quite in place for the hockey stick growth that I eventually expect. The crystal ball isn't that clear just yet. But that's the story with the US.

Looking at the bigger picture from a global perspective, I see Remote Patient Monitoring (RPM) taking off in emerging economies first, where the pent up demand is the result of needed access to healthcare - as opposed to needing to solve a cost issue. The emerging economies of China and India look quite good for RPM for example. In addition, EMEA is moving forward much faster with RPM than the US, implementing it in small pockets already.

The advance that emerging economies have in adoption is that they do not need to overcome well established ecosystems and processes. Often, new technologies are much easier to adopt without rigid systems in place.

One example of this adoption phenomenon in an adjacent market lies within the automotive industry.

Let's just look at compressed natural gas (CNG). Currently the countries with the highest number of CNG vehicles are:

·Pakistan: 2.74 million CNG vehicles

·Iran: 1.95 million CNG vehicles

·Argentina: 1.90 million CNG vehicles

·Brazil: 1.66 million CNG vehicles

·India: 1.08 million CNG vehicles

·USA: 112,000 CNG vehicles - that's 112K.

It's simple. Build as you grow, and the emerging markets have the advantage.

So, shifting gears back to healthcare, at the end of the day, the cool factor lies within the fact that the same RPM technology can help solve both the healthcare spending/cost issue as well as the access issue globally. Timing: Advantage emerging economies.

Thanks Steven. That said, is the market building much yet? I would imagine this would require some changes in behavior for medical practitioners to adopt it. Or, perhaps there is pent up demand and it will be adopted quickly.

You are correct sir. The home-based medical equipment market is potentially a larger market and more similar to a consumer market. Alternatively, on the clinical side, the equipment is certainly specialized and most could not match the volumes potentially offered on the home portable medical side.

That said, in order for distant doctors or caregivers to trust data (and make treatment decisions) coming in from afar - potentially from the other side of the world from these home portable medical devices, they too need to be somewhat specialized and certainly accurate and reliable. So a pulse oximeter for example operated from the home must be not only clinically accurate, but repeatable, portable and inexpensive enough for the masses. It's accually a taller challenge.

We actually have a medical doctor on staff, operating (literally) as a surgeon. We're applying our learning in the clinic environment and supporting that space for certain, but leveraging that capability in the home portable medical space as well. Best of both worlds -

Steven, how is this market viewed at this point? Certainly medical equipment is a large market, but it has been a large specialized market. I would think that home-based medical equipment potentially provides a significantly larger market, one that would be much more like a consumer market.

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